Long-term steroid therapy may increase perioperative morbidity in patients undergoing bowel resection.
In this study, researchers from Germany evaluated whether steroid dosage is associated with early complications after bowel resection.
The team assessed patients on prolonged steroid therapy for Crohn's disease.
They included 397 patients who underwent bowel resection with primary intestinal anastomoses for Crohn's disease, between 1982 and 2000.
Patients were divided into 3 groups based on steroid dosage. There were 73 high-dose patients (20 mg of prednisolone per day), 146 low-dose patients (< 20 mg prednisolone per day), and 177 patients who were not receiving any steroid therapy.
The team measured mortality and morbidity rates, anastomotic leakage, wound infections, intraabdominal abscesses, reoperation rate, and length of postoperative hospitalization.
Statistical analysis was performed using Fishers exact test and Students t-test.
|Increased morbidity was associated with a low preoperative hemoglobin level.|
|World Journal of Surgery|
The researchers determined that the 3 groups were similar in terms of gender, duration since first diagnosis, American Society of Anesthesiologists classification, and obesity.
They found that mortality, morbidity, anastomotic leakage, wound infections, intraabdominal abscesses, reoperation rate, and average postoperative stay were similar between the 3 groups.
The team established that the only factor associated with increased morbidity was a low preoperative hemoglobin level.
Dr Matthias Bruewer's team concluded, "In patients who are undergoing bowel resection for Crohn's disease, even high-dose prolonged preoperative systemic steroid therapy is not associated with increased postoperative complications".